Objective: It has been expected that patient with posttraumatic recurrent anterior shoulder dislocation might have limited daily life activity because of pain and apprehension of dislocation. But there have been only a small number of investigations regarding the rotator strength in this patient. The aim of this study is to find the characteristics about rotator strength of patient with posttraumatic recurrent anterior shoulder dislocation using an isokinetic testing. Method: We enrolled thirteen patients with posttraumatic recurrent anterior shoulder dislocation and fifteen sex, age-matched healthy nonathletic subjects in this controlled study. All participants were male and there were no significant differences between the two groups in age, height, weight, BMI. Isokinetic internal rotator and external rotator strength was evaluated with a Biodex Isokinetic Testing machine (Biodex Medical Systems, Shirley, NY, USA), tests were performed at 60 deg/sec and 180 deg/sec for both sides. Peak torque normalized to body weight, external rotator to internal rotator ratio, total work and fatigue were calculated for each angular velocity. The association between internal rotator and external rotator strength and shoulder instability was analyzed by comparisons with a control group. Results: Any notable differences could not be found between the two groups given all data from no symptomatic left shoulder. There were no significant differences between the two groups statistically in internal rotation strength of right shoulder. However, there has been a tendency that at all angular velocities, external rotator peak torque to body weight, total work and external rotator to internal rotator ratio were significantly lower in the anterior instability group than the control group at all angular velocities. There was no substantial difference between those groups with respect to the fatigue of external rotator and internal rotator in our study. Conclusion: The prominent characteristics of posttraumatic recurrent anterior shoulder dislocation are external rotator weakness and loss of balance with external rotator and internal rotator. Therefore selective training using this information rotator might be helpful in conservative treatment and rehabilitation.
Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.
Journal of The Korean Society of Inherited Metabolic disease
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v.17
no.3
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pp.92-95
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2017
Fabry disease (FD) is an X-linked lysosomal storage disorder caused by an ${\alpha}$-galactosidase A (GLA, MIM 300644) enzyme deficiency due to pathogenic variants in the ${\alpha}$-galactosidase A gene (GLA). The disease leads to accumulation of globotriaosylceramide (Gb3) and related glycophospholipids affecting nearly all major organ systems, with the primary sites damaged by Gb3 including renal glomeruli, myocardium, neurons of the dorsal ganglion and autonomic nervous system, and vascular endothelial and smooth muscle. Progressive deposition in these organ systems present with various clinical manifestations including acroparesthesia, renal failure and heart failure. Here, we report a Chinese male diagnosed with Fabry disease in his late $4^{th}$ decades showing improvement of acroparesthesia during enzyme replacement therapy (ERT). A 48-year-old Chinese man who presented with chronic recurrent severe burning pain in his fingers and toes since the age of 10, with worse involvement of the former visited to our clinic for further evaluation. His medical history included a transient ischemic attack aged 40 and diagnosed with stage 4-5 chronic kidney disease aged 47. In the family history, the patient's brother was found to be have Fabry disease 1 month before his visit. Except for his brother, all other members of the family are healthy. Based on his medical history and family history, he was strongly suspicious for Fabry disease. He was found to have a galactose-alpha-1,3-galactose level 4.96 (Reference range, 42.5-67.9) suggestive of Fabry disease. The followed sequencing of GLA coding region in our patient revealed hemizyosity for the mutation c.988C>T (Q330X) in Exon 7. Since ERT start, he showed significant improvement in his symptoms of burning sensation of fingers and toes. On the contrary, due to deteriorating kidney function even with ERT, he is considered for kidney transplantation. Despite of diagnostic delay until late 4th decades, ERT showed a potential improvement of acroparesthesia in our patient. However, late start of ERT can lead to poor outcome in multiorgan function. Therefore, early diagnosis with high index of suspicion followed by continuous ERT with regular monitoring have an impact on quality of life in Fabry disease.
The Journal of Korea Institute of Information, Electronics, and Communication Technology
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v.12
no.6
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pp.657-665
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2019
In this study, we conducted a study on the transcranial magnetic electrode, a method for the study of dementia and muscle pain, a neurodegenerative disease caused by an aging society, which is becoming a problem worldwide. In particular, transcranial magnetic electrodes have been studied to improve their ability to be deteriorated by dementia symptoms such as speech, cognitive ability, and memory by outputting magnetism deep into the brain using coils on the head epidermis. In this study, simulation was performed using Maxwell 3D program for the design of coil, the core of transcranial magnetic electrode. As a result of the simulation comparison between the coil designed by the previous research and the coil through the research and development, the output was found to be superior to the conventional designed coil. The graphs of the coil outputs of B-Field and H-Field are found to be symmetrical, but the symmetry between each coil is pseudo-symmetrical and not accurate. Based on these results, an experiment was conducted to confirm whether the output of the head epidermis through both coils is possible. In the magnitude field of the reverse-coil 2-coil analysis, the maximum output was 3.3920e + 004 H [A_per_meter], and the vector field showed the strongest magnetic field around 35 to 165 degrees. It was confirmed that the magnetic output canceled due to the magnetic output. In the case of the forward 2-coil, a maximum of 3.2348e + 004H [A_per_meter] similar to the reverse coil was observed, but in the case of the vector field, the magnetic output regarding the forward output and the head skin output was confirmed. However, when the height change in the output coil, the magnetic output was reduced.
Purpose : To evaluate the clinical results after anterior cruciate ligament (ACL) reconstruction with hamstring tendon and Ligament Anchor (LA) screw Materials and Methods : 103 patients (104 cases) who were followed up at least more than 2 years after ACL reconstruction were included in this study. The average period of follow-up was 36 months. The clinical results such as physical examination and Lysholm knee score and instrumented anterior laxity test with Telos were evaluated. Results : The Lysholm knee score was 57.9 in average preoeratively and improved to 95.2 in average at follow up. On the Lachman test, there were mild (+) instability in 46 cases $(45\%)$, moderate (++) in 33 $(31\%)$, severe (+++) in 25 $(24\%)$ preoperatively. 90 cases $(87\%)$ were converted to negative and 14 $(13\%)$ to mild at follow up. On Pivot-shift test, there were negative (-) instability in 22 cases $(22\%)$, mild (+) in 62 $(59\%)$, moderate (++) in 12 $(11\%)$ and severe in 8 $(8\%)$ preoperatively. 87 cases $(84\%)$ were converted to negative and 17 $(16\%)$ to mild at follow up. On instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference on 20 lb was $13.4{\pm}5.6$ (7-25) mm in average preoperatively, and was decreased to $3.6{\pm}1.5$ (1-6) mm in average at follow-up. Complications were quadriceps muscle atrophy in 27 $(30.0\%)$, saphenous nerve paresthesia in 19 $(18.3\%)$, anterior knee crepitus in 13 $(12.5\%)$ and over-penetration of screw through lateral femoral cortex in 5 cases $(4.8\%)$. Conclusion : ACL reconstruction with hamstring tendon and LA screw was one of the choice of graft and fixatives in restoring knee stability and in improving clinical results with little complications such as anterior knee pain.
The fruit of Actinidia polygama, Mock-chun-ryo in Korea, has been used as traditional medicine for abdominal pain, rheumatic arthritis, and stroke. In a previous study, the ethanol extract of A. polygama Max. showed antiinflammatory activity in RAW 264.7 cells. In this study, we investigated the anti-inflammatory and anti-atherosclerosis effects of supercritical fluid marc extracts from A. polygama Max. Anti-inflammatory extracts were produced from supercritical fluid extraction of the silver vine under the following conditions; pressure, 1,500-4,500 psi, temperature $35-55^{\circ}C$ and extraction time 1-2 hr. To evaluate the anti-inflammatory and anti-atherosclerotic effects of the extracts, we studied nitric oxide (NO), prostaglandin $E_2$ ($PGE_2$), and tumor necrosis factor-alpha (TNF-$\alpha$) levels in RAW 264.7 cells and MMP-9 activity in human aortic smooth muscle cells (HASMC). The Marc 11 extract inhibited the production of NO, $PGE_2$, and TNF-$\alpha$ by lipopolysaccharide in RAW 264.7 cells. Moreover, the marc 11 extract inhibited TNF-$\alpha$-induced MMP-9 activity in HASMC. These results indicate that the Marc 11 extract of A. polygama Max. has the potential for use as an anti-atherosclerosis agent.
Jo, Chris H.;Kim, Je-Kyoon;Yoon, Kang-Sup;Lee, Ji-Ho;Kang, Seung-Baek;Lee, Jae-Hyup;Han, Hyuk-Soo;Rhee, Seung-Whan
Clinics in Shoulder and Elbow
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v.12
no.2
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pp.199-206
/
2009
Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.
Song Eun Kyoo;Lee Keun Bae;Shin Sang Gyoo;Kim Hyun Jong
Journal of Korean Orthopaedic Sports Medicine
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v.1
no.1
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pp.21-25
/
2002
Purpose: To evaluate the clinical results after anterior cruciate ligament (ACL) reconstruction with hamstring tendon and Ligament Anchor (LA) screw, which is newly designed for fixation of graft into femur. Materials and Methods: Fifty eight patients who were followed up at least more than 2 years after ACL reconstruction with four strands of Hamstring tendon and LA screw were included in this study. The graft was fixed with LA screw at femoral tunnel and with only bioabsorbable interference screw at tibial tunnel. The mean follow-up period was 28 months. The clinical results were evaluated by physical examination and Lysholm knee score. Widening of bony tunnel and anterior laxity difference compared with normal side by instrumented anterior laxity test with Telos(R) (Telos stress device; Austin & Associates, Inc., Polston, US) were evaluated. Results: The Lysholm knee score improved from 60.0 points preoperatively to 94.0 points at last follow up. On the Lachman test, there were mild (+) instability in 16 cases, moderate (++) in 24,severe (+++) in 18 preoperatively. 50 cases were converted to negative and 8 to mild instability at postoperative follow up. On instrumented anterior laxity test with Telos(R), difference between normal and affected knee on 20 lb was 12.9 mm in average preoperatively, and was decreased to 3.1mm at last follow-up. The femoral tunnel was widened from 10.6 mm postoperatively to 12.7 mm (21.1$\%$) at follow up on antero-posterior plane and from 10.7 mm to 12.4 mm (16.5$\%$) on lateral plane. Tibial tunnels was also widened from 9.8mm to 11.8mm (20.7$\%$) on antero-posterior plane and from 9.9mm to 11.7 mm ($18.9\%$) on lateral plane. Complications were: anterior knee crepitus in 17 case, quadriceps muscle atrophy(>3 cm) in 6, penetration of screw over the lateral femoral cortex in 5, saphenous nerve paresthesia in 2.Conclusions: ACL reconstruction with hamstring tendon and LA screw was one of the choice of grafts and fixation devices in restoring knee stability and in improving clinical results with little complications such as excessive widening of bony tunnel and anterior knee pain
Purpose: To validate and introduce the technique of the arthroscopic repair for the treatment of the Subscapulris tendon tear. Materials and Methods: From April 2003 to April 2004, Arthroscopic repairs were performed in 8 patient with subscapularis tendon tear. The mean follow-up period was 11months. two cases involved only subscaplaris tendon tear. Four cases were associated small sized posterosuperir. rotator cuff tear and two cases were in large size. The type of subscapularis tendon showed upper portion full-thickness tear in 6 cases, partial-thickness tear localized at articular surface in 1 case, complete tear in 1 case. The results were analyzed by using subjective satisfaction, inferior movenent of superior displaced humeral head, Constant-Murley functional scoring Results: Constant-Murley scoring was improved from 55 point preoperatively to 75 point postoperatively following 11 months. Mean score was 71 point except 2 cases of large superoposterior rotator cuff tear, Most humeral heads were distaracted postoperatively. The subjective result for the 8 shoulders were very satisfying in 5 cases, satisfying in 1 case and dissatisfying in 2 cases. Therefore satisfactory results were noted in 6 cases (75%) of this overall treatment group. Conclusion: The arthroscopic repair for the subscapularis tendon tear is thought to be available method, which could reduce severe complications following the weakness of deltoid muscle and postoperative pain. Especially Partial Subscapularis tear not associated with superoposterior rotator cuff tear including PASTA lesion was the sutable indication of the Arthroscopic repair.
The Journal of the Convergence on Culture Technology
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v.8
no.2
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pp.227-234
/
2022
Seok Jeon Hwang Wook (18913~1999), a descendant of a traditional literary writer in the western part of Honam, did not join the flow of modern and contemporary calligraphy and painting. And throughout his life, he enjoyed himself without losing the appearance of a scholar, immersed himself in traditional calligraphy, and gained spotlight at his late age for his original hand grabbing calligraphy. Immediately after the Korean War, all of his property was lost due to his two sons' left-wing activities, causing great pain at home. Even in the most painful and difficult time in human history, he relied on brushes, poetry, and gayageum to keep his upright scholarly spirit and national love. And beyond the pleasures of the worldly senses, he played with self-satisfaction in the 'true pleasure(大樂)' without greed. In the course of his studies, he focused on honing the fonts of Wang Hui-ji, Gu Yang-sun, An Jin-gyeong, Jo Maeng-bu, and Xin-wi and Lee Sam-man without a special teacher. In particular, he faced a crisis of having to give up his brush due to tremor that came after his 60th birthday, but he showed a strong will. He transformed it into a new style of art, such as developing hand grabbing calligraphy(握筆法) with a strong and strong energy that no one could match. From 1965 to 1983, 'right hand grabbing calligraphy' was used, and from 1984 to 1993, 'left hand grabbing calligraphy' was used. She made her name as a calligrapher widely known in 1973 (age 76) with her first solo exhibition, The Calligraphy Exhibition commemorating her 60th wedding anniversary. His writing method is naturally rough and sloppy by breaking away from the previous calligraphy methods and artificial technique, and is unfamiliar yet full of muscle. And the calm, strong and rough chuhoegsa(錐劃沙) and the heavy yet majestic ininni(印印泥) individual handwriting expressed a strange feeling and achieved original Seokjeon calligraphy that went beyond the existing calligraphy writing methods, and his indomitable calligraphy spirit was As a unique existence in the history of calligraphy, he still remains as a model.
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